What are the barriers that prevent adolescents from reaching Public Health services? How many seek counseling to start sexual relationships? Do professionals really have the tools to address equitably the sexual and reproductive health needs of this population?
Las Tunas, Cuba.- These and other questions distinguished the development of workshops for the implementation of quality standards in adolescent care. The experience is being tested in Las Tunas; San Miguel del Padrón, in Havana; Cumanayagua, in Cienfuegos and Buey Arriba, in Granma, and intends to extend to the rest of the national territory.
For the initial selection, they evaluated criteria related to indicators of adolescent fertility and sexually transmitted infections, among other aspects. Currently here, of the 5,700 pregnant women, 21 percent are under 19 years of age.
"For a long time, this province registered the highest adolescent fertility in Cuba, until 2011, when Granma surpassed the number," says Libia Quintana, a professor associated with the United Nations Population Fund (UNFPA), a program that leads the initiative along with the Ministry of Public Health (Minsap).
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Pregnancy at this stage of life has repercussions not only from a personal point of view but also from a social one. Therefore, it is urgent to make the problem visible, especially in girls under 14 years of age; a phenomenon that brings with it other manifestations.
"Whenever there is pregnancy at this age we are in the presence of some form of gender violence," she says. Fertility in males of these ages is very low, however, in females, there is resistance to decline.
"We know that the parents of these children are over 20 years old, and more; which reveals an event of violence, even when the women consent it. Cuban teenage girls say that they initiate the sexual life of their own free will, but many times, it is tinged by pressure from their partner, the group of friends and others.
The specialist said that the male sex is also very exposed to the events of violence, with the so-called bullying and other forms. Within them, those who have a different orientation or gender identity from the heterosexual and do not "fulfill" the canons of virility suffer more. "They are patients who need attention in our Health areas," she adds.
For Dr. Francisca Cruz Sánchez, head of the Health and Adolescent Advisory Group of the Maternal and Child Program, the most important thing is the quality of care from health care providers. "Many times they think that this population is healthy, without realizing its risks and conflicts.
"It is necessary to look for alternatives beyond the educational talks and help from mass organizations and the family to teach them how to take care of themselves without criticizing or embarrassing them.
Precisely, the standards include, in an organized manner, the steps to follow in order to strengthen the competencies of the professionals, the dissemination in the community of the services and timely information on sexual and reproductive health, among other aspects.
Certainly, the shortage of inputs and the particularities of this age group demand an extra effort. Even so, the local professionals sealed their commitment to being part of this new challenge in favor of the health of the youngest, who are, in a short period, the country's successors.
